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General NPI Number Information
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NPI Number | 1699272450
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Entity Type | Organization
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Legal Business Name | JESSICA D KASINOFF PLLC
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Dates
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Enumeration Date | 04/09/2018
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Last Update Date | 04/09/2018
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Provider Practice Location Address
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Address Line | 871 WASHINGTON ST STE 6
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City | RALEIGH
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State | NC
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Zip | 27605-1255
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Country | US
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Telephone | 919-307-9960
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Fax |
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Provider Business Mailing Address
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Address Line | 117 GEORGETOWN RD
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City | RALEIGH
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State | NC
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Zip | 27608-2615
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | JESSICA D KASINOFF
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Credential | LCSW
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Telephone | 919-539-8223
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | C003063
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License Number State | NC
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